Maternal nutrition & low birth weight - what is really important?

The prevalence of low birth weight (LBW) is higher in Asia than elsewhere, predominantly because of undernutrition of the mother prior to and during pregnancy. There are qualitative differences in dietary requirements during early and late pregnancy - micronutrients and proteins required in early pregnancy, and calories and other nutrients later. A paradigm shift from efforts to improve size at birth, to efforts to improve foetal growth and development might provide fresh insight into the problem. Micronutrient deficiencies during pregnancy have been shown to have serious implications on the developing foetus. Nearly half the pregnant women still suffer from varying degree of anaemia, with the highest prevalence in India, which also has the highest number of maternal deaths in the Asian region. Of specific concern is compliance with iron supplementation, cultural beliefs regarding diet in pregnancy, and the issue of nutrition supplementation and fortification. The coexistence of risk of LBW or intra uterine growth retardation (IUGR) associated with essential fatty acid docosahexaenoic acid (DHA) and vitamin B12 intake or status observed in the Indian sub-continent also requires further examination. There is a significant protective effect of higher maternal education (beyond high school). Optimal weight gain during pregnancy and a desirable foetal outcome may be a result of synergistic effects of improved food intake, food supplementation, improved micronutrient intake, education and the environment of the pregnant woman and her family.